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Atrial fibrillation
97%
253/262
Transmural myocardial infarction
0%
0/262
Untreated hypertension
Torsades de pointes
2%
4/262
Ventricular hypertrophy
1%
2/262
Select Answer to see Preferred Response
This patient presents with palpitations and EKG findings consistent with atrial fibrillation. Atrial fibrillation is the most common cardiac arrhythmia. It can be precipitated by valvular heart disease, ischemia, worsening pulmonary disease, CHF, hyperthyroidism, binge drinking, increased cardiac sympathetic tone, and pericarditis. Characteristic EKG findings include: absent p waves and irregularly irregular QRS complex rhythms. Atrial fibrillation may cause new onset palpitations. Patients with atrial fibrillation are at increased risk for stroke, though anticoagulation therapy decreases this risk. Wexler et al. review the outpatient approach to palpitations. Atrial fibrillation is the most common cause of palpitations. Patients with atrial fibrillation often present with supraventricular tachycardia. Liang et al. studied 2093 patients and found that alcohol intake was associated with an increased incidence of atrial fibrillation among people aged 55 or older with cardiovascular disease or diabetes. The effect of binge drinking on the risk of atrial fibrillation was similar to that of habitual heavy drinking. Illustration A shows atrial fibrillation on EKG. Note the irregularly irregular rhythm and absent P waves. Incorrect answers: Answers 2-5: None of these conditions are associated with irregularly irregular rhythms or absent P waves.
3.9
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